Active NPI
Casandra Marie Stoll, ATC
- Athletic Trainer
- Hilton Head, SC
National Provider Identifier
1306112446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1385
- Practice address
- 95 Mathews Dr
Suite D5
Hilton Head, SC 29926-3734 - Phone
- (843) 681-5640
- Fax
- (843) 681-5631
- NPI assigned
- Mar 22, 2012
- Last updated
- Feb 6, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.003113 | IL | |
| Athletic Trainer | 2255A2300X | 1385 | SC | Primary |
Addresses
Primary practice location
95 Mathews Dr
Suite D5
Hilton Head, SC 29926-3734
Mailing address
95 Mathews Dr
Suite D5
Hilton Head, SC 29926-3734
Phone (843) 681-5640
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.003113 | IL | MD | Athletic Trainer |
| 1385 | SC | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391644800000",
"number": "1306112446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 MATHEWS DR",
"address_2": "SUITE D5",
"city": "HILTON HEAD",
"state": "SC",
"postal_code": "299263734",
"telephone_number": "843-681-5640",
"fax_number": "843-681-5631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 MATHEWS DR",
"address_2": "SUITE D5",
"city": "HILTON HEAD",
"state": "SC",
"postal_code": "299263734",
"telephone_number": "843-681-5640",
"fax_number": "843-681-5631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLL",
"first_name": "CASANDRA",
"middle_name": "MARIE",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-22",
"last_updated": "2014-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.003113",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "1385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hilton Head, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.